Journal of Korean Society of Geriatric Neurosurgery 2011;7(2):115-121.
Published online September 30, 2011.
Vertebral Compression Fractures treated by Percutaneous Vertebroplasty in Elderly Patients Over Age 80: A Radiographic Comparison of Patients Over Age 80 to Those Under 80
Sang Moon Hong , Kwan Ho Park , Tae Wan Kim , Jeil Ryu , Jae O Kim
Department of Neurosurgery, Seoul Veterans Hospital, Seoul, Korea
80세 이상의 노인 환자에서 발생한 척추체 압박골절에 대한 경피적 척추체성형술: 80세 미만 환자와 영 상학적 소견 비교
홍상문ㆍ박관호ㆍ김태완ㆍ류제일ㆍ김재오
서울보훈병원 신경외과
Abstract
Objective
An aging society is a country which has more than seven percent of persons aged 65 or over out of its entire population. In 2009, the number of elderly people in Korea account for more than 10 percent of the total population. In 2010, the average lifespan of Korean people is 79.1 years. The purpose of this study is to compare epidemiology, radiographic features of vertebral compression fractures (VCFs) and the occurrence of new VCFs between patients aged under 80 and those aged over 80.
Methods
The medical records and radiographic findings of 130 consecutive patients treated with percutaneous vertebroplasty(PVP) between January 2008 and June 2010 were retrospectively reviewed. A total of 130 patients with 166 painful vertebral fractures was identified based on clinical and radiological findings. The patients were divided into two groups according to the age. Group A included 90 patients under 80 years, 40 patients aged 80 or over were categorized into group B. Variables evaluated included age, sex, body mass index (BMI), and fracture etiology. Radiographic features were analyzed on radiographs, dual bone densitometry, CT, and MRI: bone mineral density (BMD), previous VCFs, location, type, and grade of VCFs, intravertebral cleft (IVC), volume of polymethylmetacrylate (PMMA) injected, and new VCFs. Preoperative and postoperative compression ratio were measured. Preoperative and postoperative kyphotic angle were obtained.
Results
There were 66 male and 64 female patients, with a mean age of 76.6 years(range, 65-87 years). Mean follow-up period was 18 months (range, 4-39 months). There were no significance differences in age, gender, BMI. Osteoporosis and trauma are major causes of VCFs. The most common location of fractured vertebrae is thoracolumbar levels (T11-L2) between group A and group B. In two groups, mild and wedged fractures are most common. In both groups, pre-existing VCF, BMD, location of the vertebral fracture, type and grading of fracture, IVC, PMMA volume, and new VCFs have no statistically significant difference. Postoperative compression ratio and kyphotic angle were increased in both groups.
Conclusion
The etiology of VCF is multifactorial. A majority of these fractures are related to osteoporosis and trauma. There was no significant difference in radiographic features of vertebral compression fractures in both groups. PVP for VCF provides pain relief for a majority of patients regardless of underlying age. The age over 80 is not considered as a factor to affect epidemiology, radiographic features of VCFs and the occurrence of new VCFs.
Key Words: OsteoporosisㆍVertebraㆍCompression fracture
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